A descriptive cross-sectional hospital-based survey carried out on the patients

METHODOLOGY

The design for the current study was a descriptive cross-sectional hospital-based survey carried out on the patients visiting the outpatient department (OPD).

The study protocol was cleared through the Institutional Ethics Committee of the institute. Informed consent was taken from the participants. The participants were informed that their participation in the study will be anonymous, voluntary, and non-compulsory. They were assured about anonymity and confidentiality of the information provided. The study being a descriptive one, there was no intervention involved. Hence, there was less than minimal risk to the participants.

All new patients attending dentistry OPD in the age group of 18-50 years and giving consent to participate in the study were included in the study. All the young and old patients were excluded from the study to avoid duplication.

The study participants were recruited over a period of 1 month during mid-Jan to mid-Feb 2018.

A cross-sectional study using a 16-item structured was conducted to assess oral hygiene knowledge and awareness in a sample of patients (n = 100) seeking dental care. A convenient sampling technique was adopted in the present study. Only new patients who were visiting the dental college during the study period and agreed to participate were included in the study till the estimated sample size was reached. A total of 100 patients participated in the current study. The response rate was 100%.

A self-made 16 item closed ended questionnaire written in English language was given to each one of them. The patients were selected both from rural as well as urban population and included both educated and illiterate groups between 18 to 50 years of age. All the patients were assisted by one dental hygienist so that even illiterate patients were able to fill the form or get it filled with ease.

The questionnaire was in two parts:

Part 1: Demographic details of the study participants.

Part 2: Information about practice of oral hygiene methods and awareness.

The questionnaires were handed to the patients while they were seated in the waiting area of the Department of Periodontology. At all times, one of the investigators was present with the respondent while the questionnaires were being filled to ensure that the concerned respondent did not discuss the questions or the answers with any other patients sitting in the waiting area and also to make sure that the concerned respondent fully understood the questions as well as the answers completely. After distribution of questionnaire, 10 minutes were allocated to complete the questionnaire. Results were subjected for statistical analysis.

The review of literature gave us valuable insight about the variables to be kept for this study. Variables recorded in the study were Oral hygiene maintenance material, duration of use, frequency of use, changing of brush, method of brushing, secondary method of cleaning, use of floss, halitosis, tongue cleaning, material used to clean tongue, use of mouthwash, selection criteria of toothpaste, frequency of dental visits, personal opinion on visiting dentists, knowledge about relation to systemic health.

The data was first transferred to Microsoft Excel and the results were analyzed by using SPSS statistical software in terms of percentages.

RESULTS

The present study was carried out on 100 patients. Among them, 40% were males and 60% were females. Patients were further divided on the basis of age groups; group 1 (G1) being 18-25 years and group 2 (G2) having 26-50 years old. Highest proportion was from group 2 females. Distribution of patients according to age and gender is depicted in the pie chart.

The detailed educational, work and social status distribution is depicted in the table. Showing the maximum number of undergraduate/graduates in group 1 females, highest unemployment rates in group 1 females and the most underprivileged being the group 2 females.

MALES FEMALES

G1 G2 G1 G2

Secondary Education 8 8 8 14

Undergraduate/Graduate 12 12 20 18

Employed 4 20 0 6

Unemployed 16 0 28 26

Privileged 10 8 16 14

Under privileged 10 12 12 18

On evaluation, it was revealed that the oral hygiene aids show notable difference among different group of patients. Majority of patients including both males and females preferred toothbrush and toothpaste while only 6% females preferred other cleaning aids like finger and miswak. It was further observed that majority of patients brushed their teeth twice daily (50%), 38% brushed once daily and 12% patients brushed more than twice a day. Moreover, most of the patients (48%) brushed for 2-5 minutes, while 40% for 1 minute and 12% brushed less than a minute. Besides, 68% of patients changed their toothbrush once in every three months, 16% changed it within a month, 10% changed it once in six months, 4% changed it every year and 2% changed it when the bristles were frayed.

In addition to this, 68% participants used combined brushing technique, 18% used horizontal, 12% used vertical and 8% used circular brushing method.

It was evaluated that 44% participants used toothpicks as secondary method of plaque control and 16% used dental floss. However, only 10% used interdental brush and 30% used no aid. Also, 54% participants did not use a dental floss, 32% used it occasionally, 10% used it once daily and 4% flossed twice daily.

Evaluation of halitosis lead to 68% of clients with no halitosis while the rest 32% felt bad breath from their oral cavity.

Tongue cleaning is also an important aspect of cleaning oral cavity. 70% of the participants cleaned their tongue while the rest 30% did not clean their tongue. Furthermore, 58% of the participants used a toothbrush to clean their tongue, 6% used a tongue cleaner, 6% used finger and 30% did not clean their tongue.

It was also noticed that 48% patients never used a mouthwash, 28% used it once a week while 24% used it only when prescribed by the dentist.

On a question on how they select their toothpaste 32% answered on the basis of fluoride content, 26% pleasant taste, 14% dentist recommendation, 12% advertisement, 10% packaging and 6% based on cost.

It is surprising that around 62% of the total population visit the dentist only when in problem while only 16% of the patients visit the dentist once in 6 months and 4% patients visited a dentist once in a year. Moreover, 18% patients did not even feel the need to visit a dentist. Nevertheless, 72% participants think it is essential to visit dentist every six months whereas, 28% think it is not necessary.

Regarding the relationship between oral health and systemic health, 6% of the patients did not have any idea while 94% of the participants did have some knowledge.

Lastly, the results of the study pointed out that educational level was one of the most important factors that governed the knowledge, attitude and behaviour of the people.